TB Test Professional Standards and Ethics 3 — Questions and Answers
Question 1: A nurse administers a TST but forgets to record the lot number of the tuberculin used. What should be done?
- Leave the field blank and continue
- Document 'unknown' and report the incomplete record to a supervisor (Correct answer)
- Fabricate a plausible lot number to complete the form
- Void the test and repeat it immediately
Correct answer: Document 'unknown' and report the incomplete record to a supervisor
Incomplete records should be flagged as such and reported; fabricating data is fraudulent and unethical.
Question 2: Which federal law most directly governs the confidentiality of TB test results in a healthcare setting?
- OSHA
- HIPAA (Correct answer)
- ADA
- CLIA
Correct answer: HIPAA
HIPAA (Health Insurance Portability and Accountability Act) sets national standards for protecting patient health information.
Question 3: A TB test administrator witnesses a coworker reading a TST induration incorrectly but saying nothing to the patient. The best course of action is:
- Say nothing to preserve workplace harmony
- Immediately correct the coworker in front of the patient
- Address the error privately with the coworker and notify a supervisor (Correct answer)
- Report the coworker to the state health board without speaking to them first
Correct answer: Address the error privately with the coworker and notify a supervisor
Professional standards call for addressing errors respectfully and involving supervisory oversight to ensure patient safety.
Question 4: A patient discloses they are HIV-positive before a TB test. The administrator should:
- Refer the patient elsewhere to avoid liability
- Apply a lower induration threshold when interpreting results and maintain strict confidentiality (Correct answer)
- Decline to test and notify public health
- Use a higher induration threshold since HIV increases immune response
Correct answer: Apply a lower induration threshold when interpreting results and maintain strict confidentiality
Immunocompromised patients like those with HIV require a lower positivity threshold (≥5mm), and their HIV status must remain confidential.
Question 5: What is the professional obligation when a TB test administrator is uncertain whether a result is positive or negative?
- Default to negative to avoid alarming the patient
- Document a definitive result based on best guess
- Consult a supervisor or more experienced colleague before recording (Correct answer)
- Ask the patient what they think the result is
Correct answer: Consult a supervisor or more experienced colleague before recording
When uncertain, professionals must seek consultation to ensure accurate results rather than guessing.
Question 6: A company requires all employees to submit TB test results to HR. A worker's result is positive. Who should receive this information?
- HR directly, as the employer mandated it
- Only with the employee's signed authorization and as required by law (Correct answer)
- The entire HR team for documentation purposes
- The employee's direct supervisor for scheduling purposes
Correct answer: Only with the employee's signed authorization and as required by law
Even when employers require TB testing, individual results can only be disclosed with proper authorization and in accordance with applicable law.
Question 7: Which action best demonstrates professional integrity in TB test documentation?
- Recording results immediately after reading, before memory fades (Correct answer)
- Estimating the induration size to save time
- Waiting until end of shift to batch-document all results
- Rounding induration measurements to the nearest 5mm
Correct answer: Recording results immediately after reading, before memory fades
Documenting results immediately after reading ensures accuracy and reduces the risk of memory error or data loss.
TB Test Professional Standards and Ethics 3
A nurse administers a TST but forgets to record the lot number of the tuberculin used.
What should be done?